Spontaneous cerebral haemorrhage in a young weight lifter: A case report and a review of current literature
More details
Hide details
Department of Experimental and Clinical Medicine, University of Florence, Italy
Gabriele Cioni   

Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50132 Florence, Italy. Tel.: +39 055 7949420, Fax: +39 055 7949418.
Submission date: 2017-02-22
Acceptance date: 2017-05-02
Online publication date: 2018-03-02
Publication date: 2019-11-17
Pol. Ann. Med. 2018;25(1):121–124
Intracranial haemorrhage is the leading cause of death related to a head trauma in sports, and spontaneous cerebral bleedings are a very rare condition in young athletes.

We propose the case of a young weight lifter, androgenic anabolic steroids abuser, who developed a spontaneous massive intracranial haemorrhage during exertion.

Case study:
The patient was a weight lifter at a competitive level, who had exercised on a regular basis for the past 5 years, assuming anabolic steroids and proteins for some years. Moreover, he referred a negative family history for spontaneous bleeding in the brain. At the visit time he presented very high blood pressure values.

Results and discussion:
In this case report, the side of the cerebral lesion was typical for a hypertensive brain damage. High blood pressure values, and the alteration of sodium and potassium were compatible with hyperaldosteronism; moreover, cardiac ultrasound assessment showed a hypertrophic ventricle condition, secondary to a chronic untreated hypertension.

The chronic use of anabolic steroids could contribute to hypertensive complications, such as intracranial haemorrhages.

None declared.
Broderick J, Connolly S, Feldmann E, et al. Guidelines for the management of spontaneous intracerebralhemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Circulation. 2007;116(16):e391–e413.
Cantu RC. Head injuries in sport. Br J Sports Med. 1996;30(4):289–296.
Abe A, Nishiyama Y, Kamiyama H, Kitahara I, Katsura K-I, Katayama Y. Symptomatic middle cerebral artery dissection in a young tennis player. J Nippon Med Sch. 2009;76(4):209–211.
Mohaghegh S, Hajian M. Stroke in a Young Swimmer. Asian J Sports Med. 2015;6(2):e23812.
Pego-Reigosa R, López-López S, Vázquez-López ME, et al. Sea wave-induced internal carotid artery dissection. Neurology. 2005;64(11):1980.
Alaraj AM, Chamoun RB, Dahdaleh NS, Haddad GF, Comair YG. Spontaneous subdural haematoma in anabolic steroids dependent weight lifters: reports of two cases and review of literature. Acta Neurochir (Wien). 2005;147(1):85–87.
Di Bello V, Giorgi D, Bianchi M, et al. Effects of anabolic-androgenic steroids on weight-lifters’ myocardium: an ultrasonic video densitometric study. Med Sci Sports Exerc. 1999;31(4):514–521.
Ferenchick GS, Hirokawa S, Mammen EF, Schwartz KA. Anabolic-androgenic steroid abuse in weight lifters: evidence for activation of the hemostatic system. Am J Hematol. 1995;49(4):282–288.
Kokkonen L, Anttonen O, Penttilä O, Voutilainen S. [Protein C deficiency and use of anabolic steroids behind the myocardial infarction in a young man]. Duodecim. 2001;117(22): 2279–2281 [in Finnish].
McCulloch NA, Abbas JR, Simms MH. Multiple arterial thromboses associated with anabolic androgenic steroids. Clin J Sport Med. 2014;24(2):153–154.
Kawajiri K, Kiyama M, Hayazaki K. Spontaneous dissection in the common carotid artery-case report. Neurol Med Chir (Tokyo). 1995;35(6):373–376.
Rossi GP, Seccia TM, Maniero C, Pessina AC. Drug-related hypertension and resistance to antihypertensive treatment: a call for action. J Hypertens. 2011;29(12):2295–2309.
Santos MA, Oliveira CV, Silva AS. Adverse cardiovascular effects from the use of anabolic- androgenic steroids as ergogenic resources. Subst Use Misuse. 2014;49(9):1132–1137.
Solakovic S, Totic D, Vukas H, Djedovic M. Hidden Danger of Irrational Abusing Illegal Androgenic-anabolic Steroids in Recreational Athletes Age Under 35 in Bosnia & Herzegovina. Med Arch. 2015;69(3):200–202.
Severo CB, Ribeiro JP, Umpierre D, et al. Increased atherothrombotic markers and endothelial dysfunction in steroid users. Eur J Prev Cardiol. 2013;20(2):195–201.
Hartgens F, Cheriex EC, Kuipers H. Prospective echocardiographic assessment of androgenic-anabolic steroids effects on cardiac structure and function in strength athletes. Int J Sports Med. 2003;24(5):344–351.
Jurca SJ, Elliott WJ. Common Substances That May Contribute to Resistant Hypertension, and Recommendations for Limiting Their Clinical Effects. Curr Hypertens Rep. 2016;18(10):73.
Lusetti M, Licata M, Silingardi E, Reggiani Bonetti L, Palmiere C. Pathological changes in anabolic androgenic steroid users. J Forensic Leg Med. 2015;33:101–104.
Kasikcioglu E, Oflaz H, Umman B, Bugra Z. Androgenic anabolic steroids also impair right ventricular function. Int J Cardiol. 2009;134(1):123–125.
Wysoczanski M, Rachko M, Bergmann SR. Acute myocardial infarction in a young man using anabolic steroids. Angiology. 2008;59(3):376–378.